Provider Demographics
NPI:1730238098
Name:NGUYEN, HOP TRUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:HOP
Middle Name:TRUNG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6464 W SUNSET BLVD
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-8001
Mailing Address - Country:US
Mailing Address - Phone:323-469-1665
Mailing Address - Fax:323-469-6059
Practice Address - Street 1:6464 W SUNSET BLVD
Practice Address - Street 2:SUITE 1020
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-8001
Practice Address - Country:US
Practice Address - Phone:323-469-1665
Practice Address - Fax:323-469-6059
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADM343901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB34390OtherDENTICAL